Provider Demographics
NPI:1679107676
Name:CAPERS, MARY AMANDA (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:AMANDA
Last Name:CAPERS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MCCHESNEY AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2727
Mailing Address - Country:US
Mailing Address - Phone:770-313-5055
Mailing Address - Fax:
Practice Address - Street 1:100 TAYLOR ST STE C4
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-1748
Practice Address - Country:US
Practice Address - Phone:615-601-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health